Rehabilitation using a prosthetic device

ABSTRACT

Disclosed are adjustable powered rehabilitation devices and methods for using the same to rehabilitate and/or train a user. The rehabilitation devices preferably have a plurality of selectable power settings that correspond to one or more rehabilitation-oriented actions or functions of the rehabilitation devices. For example, the power of the rehabilitation device may be selected based on a need, ability, muscle-power and/or physiological characteristics of the user. For instance, a rehabilitation device may be operated at a relatively low power setting to allow a patient to use his or her own muscle power when moving with the rehabilitation device. The rehabilitation device may also include an adjustable sensitivity level that corresponds to a user difficulty in triggering a particular rehabilitation-oriented action. The powered rehabilitation device may also temporarily be used to train a user in interacting with a passive or more conventional prosthetic device.

RELATED APPLICATIONS

The present application is a divisional of U.S. patent application Ser.No. 13/243,921, filed on Sep. 23, 2011, entitled “REHABILITATION USING APROSTHETIC DEVICE,” which is a divisional of U.S. patent applicationSer. No. 11/346,044, filed on Feb. 2, 2006, entitled “PROSTHETIC ANDORTHOTIC SYSTEMS USABLE FOR REHABILITATION,” which claims the benefit ofpriority under 35 U.S.C. §119(e) of U.S. Provisional Patent ApplicationNo. 60/649,417, filed on Feb. 2, 2005, entitled “PROSTHETIC AND ORTHOTICSYSTEMS USABLE FOR REHABILITATION,” and U.S. Provisional PatentApplication No. 60/721,622 filed on Sep. 29, 2005, entitled “PROSTHETICAND ORTHOTIC SYSTEMS USABLE FOR REHABILITATION,” the entirety of each ofwhich is hereby incorporated herein by reference and is to be considereda part of this specification.

BACKGROUND OF THE INVENTION

1. Field of the Invention

Embodiments of the invention relate to systems and methods forrehabilitation and, in particular, to powered prosthetic or orthoticsystems usable to rehabilitate and/or train a patient.

2. Description of the Related Art

The number of disabled persons and amputees is increasing each year asthe average age of individuals increases, as does the prevalence ofdebilitating diseases such as diabetes. As a result, the need forprosthetic and orthotic devices is also increasing. Conventionalorthoses are often external apparatuses used to support a joint, such asan ankle or a knee, of an individual, and movement of the orthosis isgenerally based solely on the energy expenditure of the user. Manyconventional prostheses, which include artificial substitutes for amissing limb, are also passive devices that rely mostly on the musclestrength of the user. Such passive devices can often lead to movementinstability, high energy expenditure on the part of the disabled personor amputee, gait deviations and other short- and long-term negativeeffects.

To address some of the foregoing drawbacks, some prosthetic and orthoticdevices are equipped with basic controllers that artificially mobilizejoints and are capable of powering basic motions. Certain users, such asfirst-time users, however, often may have difficulty adapting to thepowered motion of such prosthetic or orthotic devices due to a lack ofexperience, voluntary muscle control and/or balance.

SUMMARY OF THE INVENTION

In view of the foregoing, a need exists for a powered rehabilitationdevice that is adaptable to the needs and/or abilities of a user, suchas a rehabilitation device adaptable to replace or assist a variableamount of muscle function of a user. There is also a need for improvedmethods of training and rehabilitation using a powered rehabilitationdevice in place of, or in combination with, a passive prosthetic device.

In certain embodiments, a method for rehabilitation is disclosed thatincludes providing a patient with a rehabilitation device that isattachable to a limb of the patient and has an actively actuatable jointassembly. The method further includes selecting a first power level ofthe rehabilitation device, wherein the first power level is less than amaximum level of the rehabilitation device such that the patient, whenmoving, is partially assisted by the rehabilitation device while usinghis or her own muscles. The method also includes selecting, after alength of time, a second power level of the rehabilitation device,wherein the second power level is higher than the first power level andat least partially replaces muscle function of the patient, when moving,compared to the first power level.

In certain further embodiments, the aforementioned method additionallyincludes selecting a third power level of the rehabilitation device,wherein selecting the first power level corresponds to a firstrehabilitation-oriented action and selecting the third power levelcorresponds to a second rehabilitation-oriented action different thanthe first rehabilitation-oriented action. The method may also includedetermining a sensitivity level of the rehabilitation device.

In certain embodiments, a training device is disclosed for use with alimb of a patient. For example, the training device may comprise anactively actuatable joint, an interface module and a control module. Theinterface module may be configured to receive a selection of at leastone of a plurality of power settings associated with one or more motionsof the actively actuatable joint. The control module may be configuredto output at least one control signal, based at least on the selectionof the at least one power setting, indicative of a power of the activelyactuatable joint for at least partially replacing muscle function of thepatient during a first category of motion of the training device.

In certain further embodiments, the power of the actively actuatablejoint corresponds to a propulsion of the actively actuatable joint, suchas, for example, a prosthetic knee joint. In other embodiments, theactively actuatable joint may comprise other types of prosthetic jointsor an orthotic joint.

In other embodiments, a method of training a patient is disclosed. Themethod comprises providing a patient with a training device having apowered actuatable joint and being configured to attach to a limb of thepatient, wherein the training device is provided temporarily to trainthe patient to use a second prosthetic device. The method furtherincludes selecting a first power level of the training devicecorresponding to a first rehabilitation-oriented action and selecting asecond power level of the training device corresponding to a secondrehabilitation-oriented action different than the first rehabilitationoriented action. In certain embodiments, the selecting of the first andsecond power levels is based on a training level of the patient, whereinthe first and second power levels are, respectively, less than a firstmaximum power level and a second maximum power level.

In certain embodiments, a powered lower-limb prosthesis is disclosedthat has propulsive capabilities. The prosthesis includes an activelyactuatable knee joint, a user interface module and an adjustable-powermodule. The user interface module may be configured to receive aselection of at least one of a plurality of power settings. Theadjustable-power module may be configured to output one or more controlsignals for controlling an amount of power to be applied during amovement of the actively actuatable knee joint, wherein the one or morecontrol signals is based at least in part on the selection of the atleast one power setting.

In certain embodiments, a method of training an amputee is disclosed.The method includes using a first prosthetic device to perform a firstmotion by an amputee such that movement of the first prosthetic deviceis caused by a first muscle power of the amputee. The method alsoincludes replacing the first prosthetic device with a second poweredprosthetic device and using the second powered prosthetic device toperform the first motion by the amputee such that movement of the secondpowered prosthetic device is caused by a second muscle power of theamputee, wherein the second muscle power is less than the first musclepower. In addition, the method includes replacing, after using thesecond powered prosthetic device, the second powered prosthetic devicewith the first prosthetic device. In certain embodiments, the firstprosthetic device is a passive prosthetic device.

Certain embodiments of the invention include a powered rehabilitationsystem that comprises a device associated with a limb, such as aprosthetic or orthotic device, and an adjustable-power module. Theadjustable-power module is capable of selectively powering activemovement of the rehabilitation device at a plurality of different powerlevels. For example, the power level of the rehabilitation device may beadjusted to accommodate particular needs and/or abilities of a user.

Another embodiment of the invention includes a method for rehabilitationof a patient. The method comprises selectively adjusting the powerprovided to a rehabilitation device, such as a prosthetic or an orthoticdevice, based on particular needs and/or abilities of the patient. Suchselective adjusting may comprise assigning particular power levels forthe rehabilitation device to each of a plurality ofrehabilitation-oriented actions. The method may also include selectingan appropriate sensitivity level of the rehabilitation device thatdetermines an ease of initiation of certain rehabilitation-orientedfunctions of the rehabilitation device.

Certain embodiments of the invention include a machine loadable softwareprogram for a processor for controlling the movement of a rehabilitationdevice associated with a limb. The software program includes a powermodule and an interface module, which may further include a controlmodule. The interface module receives input from a user relating to thedesired operation of the rehabilitation device. For example, theinterface module may receive input indicative of a particular powerlevel and/or sensitivity level for a particular rehabilitation-orientedaction. The control module determines the appropriate power level and/oradjustments to be made to the rehabilitation device based on the userinput and/or the current power level of the rehabilitation device. Thecontrol module then outputs a control signal to an actuatable joint ofthe rehabilitation device based at least on the determination by thecontrol module.

In certain embodiments, a rehabilitation device comprises a poweredprosthetic knee device having propulsive capabilities thatadvantageously offer certain clinical benefits. For example, suchclinical benefits may include, but are not limited to: improvedkinematics (e.g., normalized pelvic obliquity, improved pelvicrotation), reduced energy consumption (e.g., oxygen consumption),restored dynamics (e.g., powered knee swing flexion/extension andpowered stance extension), functional benefits for traumatic amputees,combinations of the same and the like. Furthermore, the rehabilitationdevice may be designed to provide powered knee flexion and/or extensionaccording to the user's mobility needs, enabling the user to achieve amore natural gait.

For example, in certain embodiments, the rehabilitation device comprisesa motorized prosthetic knee for trans-femoral amputees. A motorizedactuator module may generate power according to the amputee's need toadequately execute different portions of locomotion. For instance,locomotion portions requiring specific power management may include, butare not limited to, one or more of the following: level ground walking,stair, incline ascent or descent, sitting down and standing up. Incertain embodiments, the motorized knee unit substitutes the eccentricand concentric muscle-work generally required during these types ofactions, providing for a more natural gait.

For purposes of summarizing the disclosure, certain aspects, advantagesand novel features of the invention have been described herein. It is tobe understood that not necessarily all such advantages may be achievedin accordance with any particular embodiment of the invention. Thus, theinvention may be embodied or carried out in a manner that achieves oroptimizes one advantage or group of advantages as taught herein withoutnecessarily achieving other advantages as may be taught or suggestedherein.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a block diagram of a control system for arehabilitation device according to certain embodiments of the invention.

FIG. 2 illustrates an exemplifying embodiment of a rehabilitation devicethat may use the control system of FIG. 1.

FIG. 3 illustrates an exemplifying embodiment of a first screen shot ofa user interface for the control system of FIG. 1.

FIG. 4 illustrates an exemplifying embodiment of a second screen shot ofa user interface for the control system of FIG. 1.

FIG. 5 illustrates an exemplifying embodiment of a flowchart of arehabilitation process for conditioning a patient's use of a poweredrehabilitation device.

FIG. 6 illustrates an exemplifying embodiment of a flowchart of atraining process involving a patient's temporary use of a poweredrehabilitation device.

FIG. 7 illustrates an exemplifying embodiment of a flowchart of asensitivity selection process for determining an appropriate sensitivitylevel of a powered rehabilitation device.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Embodiments of the invention disclosed herein relate generally torehabilitating and/or training a patient. In certain embodiments, anadjustable-powered prosthetic or orthotic device is used to rehabilitateand/or train the limb of a user. For example, such a rehabilitationdevice may be used by amputees to increase their movement ability,agility, and/or performance. The adjustable power feature also allowsthe rehabilitation device to be used by a broader range of persons withvarying types and/or degrees of disabilities.

Embodiments of the rehabilitation device provide a number of advantagesto users and/or therapists. For example, the powered rehabilitationdevice may provide sufficient support and stability during differenttypes of activity (e.g., normal walking, incline walking, ascending anddescending stairs) of patients who otherwise may lack sufficient musclepower to ambulate unassisted.

While the following description sets forth various embodiment-specificdetails, it will be appreciated that the description is illustrativeonly and should not be construed in any way as limiting the disclosure.Furthermore, various applications of the invention, and modificationsthereto, which may be recognized by a skilled artisan from thedisclosure herein, are also encompassed by the general conceptsdescribed herein.

The terms “prosthetic” and “prosthesis” as used herein are broad termsand are used in their ordinary sense and refer to, without limitation,any system, device or apparatus that may be used as an artificialsubstitute or support for a body part.

The term “orthotic” and “orthosis” as used herein are broad terms andare used in their ordinary sense and refer to, without limitation, anysystem, device or apparatus that may be used to support, align, prevent,protect, correct deformities of, immobilize, or improve the function ofparts of the body, such as joints and/or limbs.

The term “rehabilitation device” as used herein is a broad term and isused in its ordinary sense and refers to, without limitation, anysystem, device or apparatus used for the reconditioning or training of apatient. For example, a rehabilitation device may include a prostheticor orthotic device usable for rehabilitation. In certain embodiments,the rehabilitation device may include a device usable for training apatient that has lost a portion of a limb (e.g., due to amputation) toassist the patient in regaining mobility.

The terms “rehabilitation-oriented action” and “rehabilitation-orientedfunction” as used herein are broad terms and each is used in itsordinary sense and includes, without limitation, a particular movementor category of movements generally performed by a healthy limb and/or arehabilitation device associated with a limb. For example, arehabilitation-oriented action or function for a lower limb may includeat least one of the following: level ground walking,ascending/descending stairs and/or inclines, sitting, standing, runningor the like.

The term “power” as used herein with respect to a rehabilitation deviceis a broad term and is used in its ordinary sense and refers to, withoutlimitation, a propulsion force and/or other active movement of therehabilitation device. For example, the power of the rehabilitationdevice may relate to the amount of motorized force needed by therehabilitation device to replace or assist the functioning of remainingmuscles of the user during locomotion. For instance, the rehabilitationdevice may perform at least one of the following: active limb (e.g.,leg) swing initiation, bending and/or straightening of a limb,advancement of the limb from a trailing position, and initiation ofdesirable hip rotation during limb swing to transfer the load to theother limb.

The term “sensitivity” as used herein with respect to a rehabilitationdevice is a broad term and is used in its ordinary sense and refers to,without limitation, a level of user difficulty associated withinitiating one or more rehabilitation-oriented functions of therehabilitation device. In certain embodiments, a sensitivity levelcorresponds to an effort and/or skill needed by the patient to initiatea desired rehabilitation-oriented action. For example, a low sensitivitylevel may be associated with a narrow range of sensed angle, pressure,and/or acceleration measurements that a user attains to trigger aparticular rehabilitation-oriented function, while a high sensitivitylevel may be associated with a broad range of angle, pressure, and/oracceleration measurements that are capable of triggering the particularrehabilitation-oriented function.

The term “passive” as used herein with respect to a prosthetic device,orthotic device, rehabilitation device, or the like, is a broad term andis used in its ordinary sense, and refers to, without limitation, adevice that does not actively adjust movement and/or a position of thedevice. For instance, a passive device may rely upon the muscle power ofthe user for substantially all of the movement of the device and/or mayregulate a resistance of a joint assembly of the device. Furthermore, a“passive mode” of a powered device may refer to a state of the device inwhich movement and/or a position of the device is caused wholly bymuscle power of the user.

The features of the system and method will now be described withreference to the drawings summarized above. Throughout the drawings,reference numbers are reused to indicate correspondence betweenreferenced elements. The drawings, associated descriptions, and specificimplementation are provided to illustrate embodiments of the inventionand not to limit the scope of the disclosure.

Moreover, methods and functions described herein are not limited to anyparticular sequence, and the acts or blocks relating thereto can beperformed in other sequences that are appropriate. For example,described acts or blocks may be performed in an order other than thatspecifically disclosed, or multiple acts or blocks may be combined in asingle act or block.

FIG. 1 illustrates a block diagram of a control system 100 for arehabilitation device according to certain embodiments of the invention.In particular, the control system 100 is usable with an activelycontrolled or articulated rehabilitation device, such as a prosthetic oran orthotic device, that is associated with the movement of a limb of auser. In certain embodiments, the rehabilitation device isadvantageously adapted to mimic and/or facilitate natural movement of ahuman joint.

As shown, the control system 100 includes an actuatable joint 102 thatis actively controlled by an actuator 104. In certain embodiments, theactuatable joint 102 corresponds to a lower limb joint, such as an ankleor a knee. The actuator 104 may comprise a wide variety of actuatingmechanisms that are configured to actively adjust the actuatable joint102, such as, for example, by adjusting an angle between limb portionsattached at the actuatable joint 102. For instance, in certainembodiments, the actuator 104 may comprise a linear actuator, arotatable mechanism, a movable post or the like, controlled by amotorized module to adjust an angle between two limb portions.

The control system 100 further includes an adjustable-power module 106advantageously capable of adjusting the power supplied by the actuator104 to the actuatable joint 102. In certain embodiments, theadjustable-power module 106 outputs one or more control signals foradjusting the actuator 104.

In certain embodiments, the adjustable-power module 106 includes aplurality of power levels and/or rehabilitation settings that allow thefunctioning of the rehabilitation device to be adapted to the particularneeds and/or abilities of the user. In certain embodiments, the powerlevels correspond to amounts of user muscle function or muscle power, ofthe user's remaining muscles, replaced and/or assisted by the motorizedmovement of the rehabilitation device during motion by the user.

For instance, the power of the rehabilitation device may be set at alower level (e.g., 10% of the total power) for a first-time user who hasprevious experience with a passive prosthetic device. At this lowerlevel, the rehabilitation device replaces and/or assists a relativelylow amount of user muscle function or muscle power with respect to theactual activity level of the patient and allowing for slow and gradualadaptation to the powered rehabilitation device. That is, during initialtraining, the user is able to use the prosthesis in a similar way as thepassive prosthesis he or she was used to. A more advanced user, on theother hand, may operate the rehabilitation device at a higher powerlevel (e.g., 90% of the total power), wherein the rehabilitation devicereplaces and/or assists a larger amount of user muscle function ormuscle power, thus relying more on the user's ability to use the powerof the rehabilitation device to his or her advantage. Similar poweradjustments may also be made based on the severity of the user'sdisability. Thus, the adjustable power function may be used to assist auser to regain natural or normal gait dynamics.

In certain embodiments, the adjustable power module 106 may include acontrol drive module used to translate high-level plans or instructionsreceived from a processing module 108 into low-level control signals tobe sent to the actuator 104. For example, the adjustable-power module106 may comprise a printed circuit board that implements controlalgorithms and tasks related to the management of the actuator 104. Inaddition, the control drive module may be used to implement a hardwareabstraction layer that translates the decision processes of theprocessing module 108 to the actual hardware definition of the actuator104. In other embodiments, the control drive module may provide feedbackto the processing module 108 regarding the position or movement of theactuator 104 or actuatable joint 102.

In certain embodiments of the invention, the adjustable power module 106is located within the rehabilitation device. In other embodiments, theadjustable power module 106 may be located on the outside of therehabilitation device, such as on a socket, or remote to therehabilitation device.

The illustrated adjustable-power module 106 receives inputs from theprocessing module 108 and an interface 110. The processing module 108advantageously processes data received from the other components of thecontrol system 100. In certain embodiments, the processing module 108includes a plurality of sub-modules that comprise logic embodied inhardware or firmware or that comprise a collection of softwareinstructions. A software module may be compiled and linked into anexecutable program, installed in a dynamic link library, or may bewritten in an interpretive language such as BASIC. It will beappreciated that software modules may be callable from other modules orfrom themselves, and/or may be invoked in response to detected events orinterrupts. Software instructions may be embedded in firmware, such asan EPROM or EEPROM. It will be further appreciated that hardware modulesmay be comprised of connected logic units, such as gates and flip-flops,and/or may be comprised of programmable units, such as programmable gatearrays or processors.

In certain embodiments, the processing module 108 includes a printedcircuit board that is positioned on the rehabilitation device. Forexample, at least a portion of the processing module 108 and at least aportion of the adjustable-power module 106 may be located on the sameprinted circuit board. In other embodiments, at least a portion of theprocessing module 108 may be remote to the rehabilitation device. Insuch embodiments, the processing module 108 may communicate with otherportions of the control system 100 through wired and/or wirelesstransmissions.

In certain embodiments, the processing module 108 may also be configuredto receive through the interface module 110 user- or activity-specificinstructions from a user or from an external device. The processingmodule 108 may also receive updates to already existing instructions.Furthermore, the processing module 108 may communicate with a personalcomputer, a laptop, a portable computing device, a personal digitalassistant, a remote control device, a cellular phone or the like, todownload or receive operating instructions. Activity-specificinstructions may include, for example, data relating torehabilitation-oriented actions performable by the rehabilitationdevice.

The illustrated interface 110 advantageously receives input, such asuser input, relating to the desired operation of the rehabilitationdevice. For example, the interface 110, which may be implemented inwhole or in part in software, may allow for individual fine-tuning ofthe function of the rehabilitation device during different portions oflocomotion. For instance, the user interface may receive inputindicative of a particular power level and/or sensitivity level for aparticular rehabilitation-oriented action. The interface 110 providesthis input to the processing module 108 and/or the adjustable-powermodule 106, which determine(s) the appropriate power level and/oradjustments to be made to the actuator 104 based on the user inputand/or the current power level of the rehabilitation device.

In certain embodiments, the interface 110 comprises a device that theuser accesses to control or manage portions or functions of therehabilitation device. For example, the interface 110 may include aflexible keypad having multiple buttons or a touch screen usable toreceive information from a user. In other embodiments, the interface 110may comprise a machine-executable software program that a user and/ortherapist may access to adjust the rehabilitation device. Such asoftware program may advantageously be run on a processor, such as apersonal computer, that is remote to the rehabilitation device.

The interface 110 may also comprise means for conveying and/ordisplaying information to a user. For instance, the interface 110 maycomprise one or more light emitting diodes (LEDs), a graphical userinterface, an audible alarm, a vibrator, combinations of the same or thelike, that allow a user to send instructions to or receive informationfrom the control system 100. The interface 110 may also beadvantageously located on the rehabilitation device and/or may comprisea USB connector, an RS 232 connector or the like usable forcommunication to an external computing device.

In a further embodiment, the interface 110 comprises an input thatswitches the rehabilitation device between active and passive modes. Forinstance, during an active mode, the adjustable-power module 106actively controls the movement of the rehabilitation device (e.g., theactuatable joint 102). While in the passive mode, the rehabilitationdevice advantageously operates in a free-swing mode that allows for freemovement of the actuatable joint 102 and relies upon muscle power of theuser for movement.

The control system 100 further includes a sensor module 112. In certainembodiments, the rehabilitation device is controlled, at least in part,based on sensory data collected from a healthy (sound) limb of a user.For instance, sensory data may include information related to thepositioning and/or loading of the healthy limb, which information may bewirelessly relayed to the processing module 108 to result in one or morepredefined actions of the rehabilitation device. Examples of suchsensory control, as used with a motion-controlled prosthetic foot, aredescribed in more detail in the following applications, each of which ishereby incorporated herein by reference in its entirety to be consideredpart of this specification: U.S. patent application Ser. No. 11/056,344,filed Feb. 11, 2005, published as U.S. Patent Application PublicationNo. 2005/0197717 A1; U.S. patent application Ser. No. 11/218,923, filedon Sep. 1, 2005; and U.S. patent application Ser. No. 11/315,648, filedDec. 22, 2005.

In certain embodiments, the sensor module 112 is associated with alower-limb rehabilitation device and is attached to the lower leg (e.g.,the shin) of the healthy leg of an amputee. The processing module 108receives data from the sensor module 112 and adjusts the rehabilitationdevice to imitate the motion pattern of the healthy leg. In certainembodiments, such imitation is performed substantially in real time. Insuch an embodiment, it may be preferable that when operating on anincline or a decline, the first step of the user be taken with thehealthy leg. Such would allow measurements taken from the naturalmovement of the healthy leg prior to adjusting the rehabilitationdevice. For example, the sensor module 112 may read data (e.g., motion,load and/or position data) from the healthy limb at a rate ofapproximately 1.3 kHz. In yet other embodiments, the sensor module 112comprises a plurality of pressure sensors in an insole of the healthyleg and a processor located on the lower leg that is in communicationwith the plurality of sensors.

In certain embodiments, the sensor module 112 is used to measurevariables relating to the rehabilitation device, such as the positionand/or the movement of the rehabilitation device. In such an embodimentthe sensor module 112 is advantageously located on the rehabilitationdevice. For example, the sensor module 112 may be located near amechanical center of rotation of the actuatable joint 102 of therehabilitation device. In other embodiments, the sensor module 112 maybe located on the user's natural limb, such as a stump of an amputee,that is attached to, or associated with, the rehabilitation device. Insuch embodiments, the sensor module 112 captures information relating tothe movement of the natural limb on the user's rehabilitation-deviceside to adjust the rehabilitation device.

In certain embodiments, the sensor module 112 advantageously includes aplurality of sensors, such as accelerometers, positioned at differentlocations on the rehabilitation device. For example, the sensor module112 may comprise three accelerometers that measure acceleration of therehabilitation device in three substantially, mutually perpendicularaxes.

In other embodiments, the sensor module 112 may include one or moreother types of sensors in combination with, or in place of,accelerometers. For example, the sensor module 112 may include agyroscope configured to measure the angular speed of body segmentsand/or the rehabilitation device. In other embodiments, the sensormodule 112 includes a plantar pressure sensor configured to measure, forexample, the vertical plantar pressure of a specific underfoot area. Inyet other embodiments, the sensor module 112 may include one or more ofthe following: kinematic sensors, single-axis gyroscopes, single- ormulti-axis accelerometers, load sensors, flex sensors or myoelectricsensors that may be configured to capture data from the rehabilitationdevice and/or the user's healthy limb.

In certain embodiments, the sensor module 112 and/or processor 108 arefurther configured to detect gait patterns and/or events. For example,the sensor module 112 may determine whether the user is in a standing orstopped position, is walking on level ground, is ascending or descendingstairs or sloped surfaces, or the like.

Although the control system 100 has been described with reference toparticular arrangements, a wide variety of alternative configurations ofthe control system may be used with embodiments of the invention. Forexample, the control system 100 may further include a memory that isremote to or associated with the processing module 108 (e.g., a cache).Such a memory may store one or more of the following types of data orinstructions: an error log for the other components of the controlsystem 100; information regarding gait patterns or curves; informationregarding past activity of the user (e.g., number of steps); controlparameters and set points; information regarding software debugging orupgrading; preprogrammed algorithms for basic movements of theprosthetic or orthotic system; calibration values and parametersrelating to the sensor module 112 or other components; instructionsdownloaded from an external device; combinations of the same or thelike. Moreover, the memory may comprise any buffer, computing device, orsystem capable of storing computer instructions and/or data for accessby another computing device or a computer processor. The memory maycomprise a random access memory (RAM) or may comprise other integratedand accessible memory devices, such as, for example, read-only memory(ROM), programmable ROM (PROM), and electrically erasable programmableROM (EEPROM). In another embodiment, the memory comprises a removablememory, such as a memory card, a removable drive, or the like.

It is also contemplated that the components of the control system 100may be integrated in different forms. For example, the components may beseparated into several subcomponents or may be separated into devicesthat reside at different locations and that communicate with each other,such as through a wired and/or wireless network. For example, in certainembodiments, the modules may communicate through RS232 or serialperipheral interface (SPI) channels. Multiple components may also becombined into a single component. It is also contemplated that thecomponents described herein may be integrated into a fewer number ofmodules.

In certain embodiments, the rehabilitation device is controlled, atleast in part, by an electronic device that executes a portion of, orcommunicates with, the control system 100. For example, the electronicdevice may comprise a computer system, a personal computer, a laptop, apersonal digital assistant (PDA), a handheld device, a cellular phone,or the like for executing software that controls functions of therehabilitation device. Such an electronic device may communicate withthe rehabilitation device through wired and/or wireless communications(e.g., radio frequency, Bluetooth, infrared, or the like).

FIG. 2 illustrates a rehabilitation device 200 according to certainembodiments of the invention. In certain embodiments, the rehabilitationdevice 200 utilizes the control system 100 of FIG. 1 to actively controlrehabilitation-oriented functions of the rehabilitation device 200. Theillustrated rehabilitation device 200 advantageously attaches to a stumpof a lower limb of an amputee and is usable to assist and/or replacepower expended by the remaining muscles of the amputee (e.g., the upperleg muscles) to ambulate with the rehabilitation device.

As shown, the rehabilitation device 200 comprises a powered prostheticknee joint usable to mimic normal movement of a healthy leg. Forexample, an electronic control system of the rehabilitation device 200may adjust external propulsive capabilities of the rehabilitation deviceby controlling an actuatable knee joint 202. In certain embodiments, theactuatable knee joint 202 may include a motorized module that couples toa transtibial post connecting to a prosthetic foot 214. For example, theprosthetic foot 214 may include a configuration disclosed in U.S. patentapplication Ser. No. 10/642,125, filed Aug. 15, 2003, and published asU.S. Patent Application Publication No. 2005/0038524 A1, which is herebyincorporated herein by reference in its entirety to be considered a partof this specification.

For instance, in certain embodiments, an adjustable-power module 206and/or a processing module may adapt the power of the actuatable kneejoint 202 by executing a series of software instructions that take intoaccount a height, weight, experience, and/or intendedrehabilitation-oriented action of the user.

In certain embodiments, the rehabilitation device 200 comprises anactive (or powered) mode and a free-swing mode. During the active mode,the adjustable-power module 206 actively controls movement of theactuatable knee joint 202, as discussed in more detail above. Such anactive mode advantageously provides for an automatic movement of therehabilitation device 200. In the passive mode, the rehabilitationdevice 200 operates in a free-swing mode that allows for free movementof the actuatable knee joint 202, as opposed to other powered prostheticdevices that become stiff when powered down. Such a passive modeadvantageously allows a user to maintain a particular gait by using hisor her own muscle strength (e.g., upper leg strength) and range ofmotion of his or her stump.

In certain embodiments, the rehabilitation device 200 further comprisesa plurality of LEDs that indicate the status of operation of therehabilitation device 200. For example, at least one LED may confirm thestatus of the communication between the rehabilitation device 200 and acorresponding sensor module. Audible alarms may also be used to indicatethe battery level, the calibration status of the rehabilitation device200, combinations of the same and the like.

In certain embodiments, the rehabilitation device 200 may furthercomprise a rubber socket cover that protects a socket of the device 200and/or a front and rear hood that protects inner components of therehabilitation device 200 (e.g., the adjustable-power module 206, anactuator, an input/output (I/O) module, processing module, and thelike).

The rehabilitation device may also take on other lower-limbconfigurations, such as those described in the following patents andapplications, each of which is hereby incorporated herein by referencein its entirety to be considered part of this specification: U.S. patentapplication Ser. No. 10/721,764, filed Nov. 25, 2003, and published asU.S. Patent Application Publication No. 2004/0181289 A1; U.S. patentapplication Ser. No. 10/627,503, filed Jul. 25, 2003, and published asU.S. Patent Application Publication No. 2004/0088057 A1; U.S. patentapplication Ser. No. 10/600,725, filed Jun. 20, 2003, and published asU.S. Patent Application Publication No. 2004/0049290 A1; U.S. patentapplication Ser. No. 11/123,870, filed on May 6, 2005; U.S. patentapplication Ser. No. 11/077,177, filed on Mar. 9, 2005, and published asU.S. Patent Application Publication No. 2005/0283257 A1; U.S. Pat. No.6,610,101, issued on Aug. 26, 2003; and U.S. Pat. No. 6,764,520, issuedJul. 20, 2004.

In certain embodiments, the illustrated rehabilitation device 200advantageously utilizes artificial intelligence that operates withinhigh and low-level software layers to continuously observe the state ofthe respective human system interface. For example, the high-level codemay be responsible for the management of biomechanical events and theamputee-device interaction, such as by calculating an appropriate powerlevel needed to perform a particular rehabilitation-oriented function.The low-level code may manage the interaction between the rehabilitationdevice 200 and a respective instrumented foot having sensor components.

FIG. 3 illustrates an exemplifying embodiment of a screen display 300 ofa user interface for receiving input relating to the control of arehabilitation device, such as the rehabilitation device 200 of FIG. 2.In particular, the screen display 300 comprises a graphical userinterface that may be used to gather data from a user, such as a patientor a therapist (e.g., a prosthetist or an orthotist), for controllingthe rehabilitation device.

As shown, the screen display 300 includes a plurality of selectable tabs320 that correspond to settings for a plurality ofrehabilitation-oriented functions. For example, a user may select any ofthe tabs 320 to access and/or input information pertaining to therespective rehabilitation-oriented function of the rehabilitationdevice. As shown, the tabs 320 include a “General” tab 321 thatactivates user input widows for receiving physiological data of the userand/or configuration data of the rehabilitation device.

As illustrated, when the “General” tab 321 is selected, the screendisplay 300 includes an amputee window 322 for receiving physiologicalparameters relating to the user of the rehabilitation device. Inparticular, the amputee window 322 may receive information relating tothe user's height, the user's weight, an identification of the amputatedlimb (e.g., left or right leg), and an experience level of the user. Inother embodiments, the amputee window 322 may be configured to collectand/or display additional or less information as appropriate.

In certain embodiments, the parameters inputted through the amputeewindow 322 may be used to calculate a default power of therehabilitation device. For instance, the experience level setting may beused to select between a variety of power levels that each correspond toa percentage of the maximum default power of the rehabilitation device.Such embodiments enable a user to fine-tune a power of therehabilitation device according to the needs and/or abilities of theuser. For example, a ten-level power system may include three beginnerlevels (e.g., Beginner L1, L2 and L3), four intermediate levels (e.g.,Intermediate L1, L2, L3 and L4) and three advanced levels (Advanced L1,L2 and L3), wherein each of the levels corresponds to approximately tenpercent of the maximum default power of the rehabilitation device. Thatis, as the user progresses in his or her ability to use therehabilitation device, the power settings of the rehabilitation devicemay be increased to alleviate the amount of muscle power expended by theuser. In yet other embodiments, the power settings(s) of therehabilitation device may be selected to compensate for lost musclefunction of the user.

The screen display 300 further includes a prosthesis window 324 thatreceives input relating to a calibration of the rehabilitation device.In particular, the prosthesis window 324 allows a user to set acalibration time for the rehabilitation device. For example, thecalibration time may determine how long a user must use therehabilitation device before the rehabilitation device will enter anactive, or powered, mode. Such a calibration time may enable therehabilitation device to gather and/or analyze data collected by asensor module prior to active movement of the rehabilitation device.

FIG. 4 illustrates the screen display 300 with a “Descending Ramps” tab421 selected from the plurality of tabs 320. In certain embodiments,selecting the “Descending Ramps” tab 421 allows a user to access inputsand/or dialog boxes for adjusting parameters of the rehabilitationdevice relating to user movement while traveling down a ramp.

As illustrated, the screen display 300 includes a stance window 430, aheel rise window 432 and a detection window 436. The stance window 430allows a user to adjust an amount of flexion support of therehabilitation device. For instance, the adjustable flexion supportvalue may correspond to how much resistance to bending the prostheticknee is provided when a majority of the user's weight is shifted ontothe rehabilitation device.

The heel rise window 432 allows a user to adjust a flexion target angleof the rehabilitation device. For instance, the flexion target angle mayinclude a desired angle to which the prosthetic knee of therehabilitation device will rise when the user shifts his or her weightto the corresponding healthy leg.

The detection window 436 allows a user to adjust a sensitivity of therehabilitation device. In certain embodiments, the sensitivity scaledetermines the ease of the initiation of the rehabilitation-orientedactions by the rehabilitation device, as discussed in more detail above.For instance, a lower sensitivity level may indicate that more effortand/or skill is required from the user-amputee to initiate the desiredaction (e.g., descending a ramp) of the rehabilitation device. Thus, thesensitivity can be adjusted to the experience and/or ability of theuser.

Although FIGS. 3 and 4 illustrate particular embodiments of the screendisplay 300, a variety of alternative configurations or types ofdisplays may be used. For example, parameters for the plurality ofrehabilitation-oriented functions may be input through menus accessiblethrough hypertext links and/or on one or more web pages. In otherembodiments, one or more settings may by input through an interfacedevice attached to the rehabilitation device.

FIG. 5 illustrates an exemplifying embodiment of a flowchart of arehabilitation process 500 usable by a therapist and/or patient inconnection with the use of a rehabilitation device, such as therehabilitation device 200 of FIG. 2. In certain embodiments, therehabilitation process 500 is performed in whole or in part during oneor more visits between a patient and his or her therapist (e.g.,prosthetist).

At the beginning of rehabilitation, a user often has difficultyperforming various rehabilitation-oriented actions due to lack ofskills, voluntary control and/or body balance. The rehabilitationprocess 500 described herein advantageously facilitates the user'sprogress in restoring symmetry, balance and/or power to user movement,such as, for example, a gait of the user.

The rehabilitation process 500 begins with Block 505 wherein thetherapist provides a patient with a rehabilitation device. In certainembodiments, the therapist fits the patient with the rehabilitationdevice and configures initial parameters related thereto. For example,the therapist may access a user interface having one or more screendisplays, such as those shown in FIGS. 3 and 4, to input one or moreinitialization parameters.

In certain embodiments, to aid in the rehabilitation process, aprosthetist also obtains certain demographic and/or physiological datarelating to the user. For example, the prosthetist may gatherinformation regarding the user's age, time since amputation, length ofexperience with a prosthetic device, weight, height, body mass index(BMI), combinations of the same or the like. Certain of thesemeasurements may be obtained during an initial training session, whileother of the variables may be collected during successive trainingsessions by the user. For example, the BMI of the user may be calculatedduring each training or gait analysis session to document anyanthropometrical changes that may influence kinetic calculations forgait analysis.

At Block 510, the therapist selects a power level for the rehabilitationdevice, such as for example, to correspond to the needs and/or abilityof the patient. In certain preferred embodiments, the therapist selectsa power level for one or more of a plurality of rehabilitation-orientedfunctions. For example, the therapist may set an initial power level forat least one of the following: standing, sitting, ascending stairs,descending stairs, ascending ramps, and descending ramps. Such input maybe received through a user interface, such as by accessing theappropriate tabs 320 and inputting data through the screen display 300.

At Block 515, the therapist determines if the power level of therehabilitation device is at a maximum power level. In embodimentswherein multiple power levels are set, the prosthetist may determine ifeach of the selected power levels is at a maximum level. If the powerlevel of the rehabilitation device is set at the maximum level, therehabilitation process 500 proceeds with Block 520 wherein the patientcontinues to use the rehabilitation device at the maximum power level.

In certain embodiments, the “maximum power level” of the rehabilitationdevice may be patient-specific and may depend on different factorsassociated with the patient using the rehabilitation device. Forinstance, a maximum power level of a rehabilitation device for a40-kilogram child may be less than a maximum power level of therehabilitation device being used by a 100-kilogram adult.

In other embodiments, the maximum power level may correspond to amaximum default level of the rehabilitation device for a particularrehabilitation-oriented function. For example, a maximum power level forlevel-ground walking may correspond to the full propulsion capability ofthe rehabilitation device.

If the rehabilitation device is not operating at the maximum powerlevel, the rehabilitation process moves to Block 525. At Block 525, thetherapist observes the patient's use of the rehabilitation device, suchas for example in a rehabilitation facility. In certain embodiments, thetherapist may also analyze data automatically collected with respect touser movement and/or movement of the rehabilitation device. For example,a prosthetist may monitor the gait efficiency and/or biomechanical gaitpatterns of the amputee. In certain embodiments, for safety reasons, asensitivity setting of the rehabilitation device may be reduced to amoderate or low level when the user leaves a training facility so as toavoid undesired triggering of a particular rehabilitation-orientedaction by the rehabilitation device.

At Block 530, the therapist determines if the patient is conditioned foran increase in the power level of the rehabilitation device. Forinstance, the therapist may determine if the patient has rehabilitatedto a point whereat the patient may comfortably handle an increase in thepower of the rehabilitation device. If the patient is not ready for anincrease in power of the rehabilitation device, the rehabilitationprocess 500 returns to Block 525, and the therapist continues his or herobservation of the patient.

On the other hand, if the patient has rehabilitated to the point whereatthe patient is ready for an increase in the power level of therehabilitation device, the rehabilitation process 500 proceeds withBlock 535, and the therapist increases the power level of therehabilitation device. In certain embodiments, the therapist mayincrease the power level relating to one or more rehabilitationfunctions depending on the patient's ability in each of the functions.The rehabilitation process 500 then returns to Block 515 to determine ifthe increased power level is at a maximum power level of therehabilitation device.

In certain embodiments, the rehabilitation process 500 for an amputeelasts for several weeks (e.g., 8 weeks), during which the patient mayparticipate in several observation sessions (e.g., weekly sessions) withhis or her therapist. Although the rehabilitation process 500 has beendescribed with reference to particular embodiments, other acts or blocksmay be used, or certain acts or blocks may be bypassed, in therehabilitation of a patient. For instance, the rehabilitation process500 may be performed without Block 505, such as with a patient who comesto a therapist pre-fitted with a rehabilitation device.

FIG. 6 illustrates an exemplifying embodiment of a flowchart of atraining process 600 usable by a patient to train for using a second,passive-type prosthetic device. In particular, a patient may perform thetraining process 600 by temporarily using an adjustable-powerrehabilitation device, such as the rehabilitation device 200 of FIG. 2.Such training allows the rehabilitation device to be temporarily usedby, or rented by, multiple patients and provides a more cost-effectivetraining process without requiring each patient to purchase a poweredrehabilitation device. For exemplifying purposes, the followingdescription of the training process 600 will be with reference to arehabilitation device that comprises a powered prosthetic leg thatsimulates a natural, human gait and that is used to train an amputee howto walk more normally using a passive prosthetic leg. The rehabilitationdevice may also be used to help correct an unnatural gait developed byan amputee while using a more conventional prosthesis.

The training process 600 begins with Block 605, wherein a patient uses apassive prosthetic device. Such passive devices may include, forexample, a prosthetic leg that is free swinging, dampening-controlled,and/or that is not power controlled and that rely upon the user's musclefunction for movement. In certain embodiments, users of a RHEO KNEEprovided by Össur, a C-LEG® provided by Otto Bock, a free-swinging knee,or the like, may train with the powered rehabilitation device. At Block610, the patient removes the passive prosthetic device and replaces theprosthetic device with a powered rehabilitation device.

At Block 615, the patient trains temporarily with the poweredrehabilitation device. For example, the patient may use therehabilitation device for a specific training period (e.g., a period ofhours or days). Such training may, in certain embodiments, be under thesupervision of a prosthetist and/or take place in a rehabilitationfacility.

With respect to rehabilitation, the user may train periodically bywalking with the powered rehabilitation device in an “off” or passivemode. This allows the user to further control the conditions under whichhe or she trains. For example, training may take place at a physicaltherapy facility or at a gym on an exercise machine, such as treadmill.In certain embodiments, the rehabilitation device alerts the userthrough an auditory, visual and/or vibratory alarm that therehabilitation device is being powered off and/or entering a passivemode. Furthermore, in certain embodiments, when the rehabilitationdevice is powered off, the user is able to manually lock the device in adesired position.

At Block 620, the patient removes the powered rehabilitation device oncehe or she has completed her training session and returns to using his orher passive prosthetic device (Block 625). Preferably, the amputee iscapable of using the passive prosthetic device to ambulate with a morenatural gait developed from his or her training.

Although described with reference to particular embodiments, thetraining process 600 may be performed with more or fewer blocks or actsthan those depicted in FIG. 6. For example, in yet other embodiments,the amputee may train with an embodiment of the powered rehabilitationdevice before substantial use of a more conventional prosthesis.

FIG. 7 illustrates an exemplifying embodiment of a flowchart of asensitivity selection process 700 for determining an appropriatesensitivity level of a rehabilitation device according to the needsand/or abilities of a patient. In particular, a therapist may performthe selection process 700 to assist the patient in tuning a sensitivitylevel setting of a powered rehabilitation device, such as therehabilitation device 200 of FIG. 2.

The sensitivity selection process 700 begins with Block 705 wherein atherapist provides a patient with a rehabilitation device. At Block 710,the therapist selects a maximum sensitivity level for a particularrehabilitation-oriented function (e.g., stair climbing). For instance,the therapist may enter the sensitivity selection through a userinterface, such as one similar to the screen display 300 depicted inFIG. 4.

In certain embodiments, the maximum sensitivity level corresponds torelatively low effort and/or skill level of the patient needed toinitiate the particular rehabilitation-oriented action. For example, themaximum sensitivity level may include the broadest range of sensedangle, pressure, and/or acceleration measurements that are capable oftriggering the particular rehabilitation-oriented function.

For instance, a lower-limb rehabilitation device may be capable ofautomatically initiating a stair ascent function when a correspondingsensing module detects, among other things, the elevation of the user'shealthy leg to a particular angle. The maximum sensitivity level forstair ascent locomotion may then correspond to the largest range ofangular tilt that is capable of triggering the stair ascent function ofthe rehabilitation device.

In other embodiments, the maximum sensitivity level may correspond tothe last sensitivity level achieved by the patient during his or herprior training session. Beginning training at a maximum sensitivitylevel also advantageously allows the patient to practice and/orfine-tune his or her movements to trigger a desiredrehabilitation-oriented action by the rehabilitation device. In yetother embodiments, the selected sensitivity level may correspond to aplurality of rehabilitation-oriented actions.

At Block 715, the patient trains by using the rehabilitation device atthe selected sensitivity level. For instance, the patient may train byrepeatedly performing the particular rehabilitation-oriented action(s)associated with the selected sensitivity level. Such training, incertain embodiments, is preferably under the supervision of a therapistand/or takes place at a designated rehabilitation facility.

If the patient is not able to comfortably manage the operation of therehabilitation device at the selected sensitivity level (Block 720), thesensitivity selection process 700 continues with Block 725. Forinstance, the therapist may determine that during the training periodthe patient unexpectedly triggered the particularrehabilitation-oriented action a relatively high number of times and/orwas not able to consistently trigger the particularrehabilitation-oriented action when desired.

At Block 725, it is determined whether the current training session hasbeen completed. If so, the therapist preferably turns off thesensitivity function of the rehabilitation device so that patient doesnot experience unexpected initiations of the particularrehabilitation-oriented function(s) while using the rehabilitationdevice at home and/or outside the training session (Block 730). However,if the current training session has not yet completed, the sensitivityselection process 700 proceeds with Block 715 wherein the user continuesto train at the selected sensitivity level.

With reference back to Block 720, if the therapist determines that thepatient has managed the rehabilitation device at the selectedsensitivity level, the therapist may then determine if the desiredsensitivity level has been reached (Block 735). For example, a desiredsensitivity level may correspond to a sensitivity level that thetherapist believes is safe for home use by the patient. In certainembodiments, the desired sensitivity level is a medium level that isless than the maximum sensitivity level but higher than the lowestavailable sensitivity level.

If the patient has not yet achieved the desired sensitivity level, thetherapist may then reduce the sensitivity level of the rehabilitationdevice (Block 735), and the patient continues training at the lowersensitivity level (Block 715). For instance, in the example discussedabove in Block 710 with respect to ascending stairs, reducing thesensitivity level may correspond to reducing the range of angular tiltthat the user must achieve with his or her healthy leg to trigger astair ascent function by the rehabilitation device.

However, if the patient has reached the desired sensitivity level, thetraining session may be terminated and the patient may be allowed tooperate the rehabilitation device at the desired sensitivity levelduring home use (Block 745).

Although described with reference to particular embodiments, thesensitivity selection process 700 may be performed with more or fewerblocks or acts than those depicted in FIG. 7. For example, in yet otherembodiments, the sensitivity selection process 700 may also include aselection of one or more adjustable power settings of the rehabilitationdevice during the user training. For instance, certain blocks of bothFIGS. 5 and 7 may be performed during a training/rehabilitation sessionto determine both an appropriate power level and sensitivity level forone or more rehabilitation-oriented functions.

For exemplifying purposes, certain aspects of rehabilitation-orientedfunctions of a power rehabilitation device will now be described. Inparticular, the following disclosure provides examples of how a user mayinteract with a lower-limb rehabilitation device to perform certainrehabilitation-oriented actions.

Initiating Locomotion

In certain embodiments, while walking on a level surface or a ramp, theuser may take a first stride with his or her healthy leg, touching theground with the heel first. This contact with the ground is detected bya sensor. The user then brings his or her hip forward such that thatrehabilitation device lifts off the ground and swings forward.

Sitting Down

In certain embodiments, the user shifts his or her body weight to theheels of both the healthy leg and the rehabilitation device. The userthen bends both legs, in response to which the rehabilitation device maypartially support the user as the user is lowering down. Once therehabilitation device reaches a given or target flexion angle (e.g.,representing a sitting position) for approximately 0.5 second, thedevice may automatically relax or enter a passive state.

Standing

In certain embodiments, the user leans slightly forward and places theforefoot of the rehabilitation device on the ground, using his or herhand to help bend the rehabilitation device if necessary. The user thenplaces his or her weight on both the healthy leg and the rehabilitationdevice to begin standing, in response to which the rehabilitation devicemay assist the user while standing. If the user desires to sit downagain, the user may stop the device extension for a certain length oftime such that the rehabilitation device re-enters a passive state orallows for transition to the sitting position.

Transitions to and from Stairs

In certain embodiments, when ascending stairs, the user may first cometo a stop and then elevate the healthy leg to the first step such thatthe forefoot of the healthy leg contacts the step. The user may thencontact the next step with the forefoot of the rehabilitation device.The user transfers his or her weight onto the rehabilitation device, inresponse to which the rehabilitation device assists the user elevate. Inyet other embodiments, the user may enhance the rehabilitation device'sability to detect stair ascent by exaggerating the lifting of thehealthy foot on the first step and by bringing his or her body weightforward to the healthy side.

To stop ascending stairs, the user may place the healthy foot flat onthe ground and avoid ground contact with the rehabilitation device for acertain length of time until a “stable” position is detected. In certainembodiments, to transition immediately from stair ascending to level orramp walking, the user may reduce his or her locomotion speed whenreaching the end of the stairs and contact the top step with the heel ofthe healthy leg. The rehabilitation device then detects level groundwalking and adjusts accordingly.

In certain embodiments, when descending stairs, the user may first cometo a stop and then begin descending the stairs by contacting the firststep with the heel of the rehabilitation device. The user then transfershis or her body weight onto the rehabilitation device, in response towhich the device performs a controlled flexion assisting the user downthe step. The user brings his or her healthy leg forward by placing theforefoot of the healthy leg on the next step. The rehabilitation devicethen bends and actively swings forward to the next step. In certainembodiments, to stop descending the stairs, the user places the healthyfoot flat on the ground and avoids ground contact with therehabilitation device for a certain length of time until the “stable”position is detected. In situations where the user reaches the bottom ofthe stairs with the rehabilitation device first, the user may then takea very short step with the healthy leg heel. If the user reaches thebottom of the stairs with the healthy leg first, the user may then puthis or her healthy foot heel-first on the ground and may take a longstride to swing the rehabilitation device more easily off the last step.

In yet other embodiments, such transitions with the rehabilitationdevice may be accomplished without the user coming to a full stop. Forexample, the rehabilitation device may detect a decrease in theacceleration of the user prior to transitioning to or from stairs.

While certain embodiments of the invention have been described, theseembodiments have been presented by way of example only, and are notintended to limit the scope of the disclosure. For example, embodimentsof the rehabilitation device described herein may comprise anyprosthetic or orthotic device that utilizes an adjustable power range tofacilitate movement of a user (e.g., hip, ankle, arm). Indeed, the novelmethods and systems described herein may be embodied in a variety ofother forms; furthermore, various omissions, substitutions and changesin the form of the methods and systems described herein may be madewithout departing from the spirit of the inventions. The accompanyingclaims and their equivalents are intended to cover such forms ormodifications as would fall within the scope and spirit of thedisclosure.

What is claimed is:
 1. A method of training a patient, the methodcomprising: providing a patient with a training device having a poweredactuatable joint, the training device being configured to attach to alimb of the patient, wherein the training device is provided temporarilyto train the patient to use a second prosthetic device; selecting afirst power level of the training device corresponding to a firstrehabilitation-oriented action; and selecting a second power level ofthe training device corresponding to a second rehabilitation-orientedaction different than the first rehabilitation oriented action, whereinsaid selecting the first and second power levels is based on a traininglevel of the patient, and wherein the first and second power levels are,respectively, less than a first maximum power level and a second maximumpower level.
 2. The method of claim 1, wherein the first maximum powerlevel is based on at least one physiological parameter of the patient.3. The method of claim 1, wherein the first maximum power level isassociated with a maximum amount of propulsion of the training device.4. The method of claim 1, wherein at least one of said selecting thefirst power level and said selecting the second power level is based atleast in part on sensory data collected from a corresponding healthylimb of the patient.
 5. The method of claim 1, wherein the first andsecond rehabilitation-oriented actions are selected from the groupconsisting of level-ground walking, ascending stairs, and descendingstairs.
 6. The method of claim 1, wherein the second prosthetic deviceis a passive prosthetic device.
 7. The method of claim 1, additionallycomprising selecting a sensitivity level of the training device.
 8. Themethod of claim 7, wherein said selecting the sensitivity level of thetraining device further comprises decreasing, after a second length oftime, the sensitivity level of the training device, wherein decreasingthe sensitivity level is associated with an increase in an ability ofthe patient to trigger a rehabilitation-oriented function by thetraining device.
 9. The method of claim 8, wherein the sensitivity levelis selected from sensitivity level settings comprising at least a highand a low setting.
 10. A method of training an amputee, the methodcomprising: using a first prosthetic device to perform a first motion byan amputee such that movement of the first prosthetic device is causedby a first muscle power of the amputee; replacing the first prostheticdevice with a second powered prosthetic device; using the second poweredprosthetic device to perform the first motion by the amputee such thatmovement of the second powered prosthetic device is caused by a secondmuscle power of the amputee, wherein the second muscle power is lessthan the first muscle power; and replacing, after using the secondpowered prosthetic device, the second powered prosthetic device with thefirst prosthetic device.
 11. The method of claim 10, wherein the firstprosthetic device is a passive prosthetic device.
 12. The method ofclaim 10, further comprising selecting a power level for the secondpowered prosthetic device based at least on the second muscle power. 13.The method of claim 12, wherein the power level is associated with anamount of propulsion of the second powered prosthetic device.
 14. Themethod of claim 12, wherein the power level is further based on at leastone of one physiological parameter of the patient and sensory datacollected from a corresponding healthy limb of the patient.
 15. Themethod of claim 10, wherein the first motion is associated with at leastone of level-ground walking, ascending stairs, and descending stairs.